Provider Demographics
NPI:1700211836
Name:PRINGLE, BRANDI P
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:P
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 PAR FOUR WAY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-1848
Mailing Address - Country:US
Mailing Address - Phone:407-953-6455
Mailing Address - Fax:770-864-1565
Practice Address - Street 1:6303 PAR FOUR WAY
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-1848
Practice Address - Country:US
Practice Address - Phone:407-953-6455
Practice Address - Fax:770-864-1565
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22370225200000X
GAPTA002943225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant